(1) For each designated service area in the state, the certified early intervention service broker for the area shall:
Establish a registry of qualified early intervention service providers to provide earlyintervention services to eligible children in the designated service area. The certified early intervention service broker for a designated service area may provide early intervention services directly or may subcontract the provision of services to other qualified providers on the registry.
Accept and process claims for reimbursement for early intervention services provided under this part 7 by qualified providers;
Negotiate for the payment of early intervention services provided to eligible childrenin the designated service area by qualified providers, to the extent permissible under federal law; and
Ensure payment to a qualified provider for early intervention services rendered bythe qualified provider.
Certified early intervention service brokers shall use procedures and forms determined by the department to document the provision or purchase of early intervention services on behalf of eligible children. Invoices or insurance claims for early intervention services shall be submitted based on the available funding source for each eligible child and the reimbursement rate for the appropriate federal, state, local, or private funding sources, including public medical assistance and private health insurance.
The department shall establish a schedule of fees to be charged by certified earlyintervention service brokers for providing broker services under this part 7. In developing the fee schedule, the department shall obtain input from certified early intervention service brokers and shall consider the duties of brokers under this part 7, the expenses incurred by brokers, and the relevant market conditions.
Use of a certified early intervention broker is voluntary; except that private healthinsurance carriers that are included under section 10-16-104 (1.3), C.R.S., are required to make payment in trust under section 27-10.5-709. Nothing in this part 7 prohibits a qualified provider of early intervention services from directly billing the appropriate program of public medical assistance or a participating provider, as defined in section 10-16-102 (46), C.R.S., or from directly billing a private health insurance carrier for services rendered under this part 7 for insurance plans that are not included under section 10-16-104 (1.3), C.R.S.
To the extent requested by the department, certified early intervention service brokers shall participate in ongoing reviews of funding practices for early intervention services and the development or revision of procedures for a coordinated system of payment for early intervention services.
Source: L. 2008: Entire part R&RE, p. 1465, § 11, effective August 5. L. 2009: (4) amended, (HB 09-1237), ch. 216, p. 979, § 3, effective May 2. L. 2013: (4) amended, (HB 131266), ch. 217, p. 994, § 68, effective May 13.
Editor's note: This section is similar to former § 27-10.5-705 as it existed prior to 2008.